Despite the government’s
aggressive approach in criminally prosecuting fraudulent providers, a report
from the Department of Health and Human Services
inspector general found that Medicare’s new
accounting system failed to automatically extract critical data regarding
providers. This failure may lead to the
inability to collect more than $543 million in overpayments to Medicare
providers.
In 2010, Medicare overpaid
providers more than $9.6 billion. Since
that time, Medicare has implemented a new accounting system – a system that
failed to automatically extract provider and contractor information from the
old accounting system. As a result,
Medicare does not have provider or contractor information critical to
collecting from those that were previously overpaid.
In addition, the new Medicare
accounting system allows information about providers to remain outdated, with
little consequence for providers who fail to update their contact
information. Providers receive payments
via direct deposit, thus eliminating the incentive to ensure that Medicare has
a correct address in its accounting system.
According to agency spokesman Brian
Cook, “Reducing the incidence of overpayments is a high priority for [Medicare].” However, once a provider has been overpaid,
having detailed information regarding the provider, such as a proper contact
address, is critical to notifying the provider and collecting any overpayments.
While criminal
prosecution of fraudulent providers continues to remain a priority for the
government, the inspector general’s report highlights glaring deficiencies in
Medicare’s new accounting system.
Medicare should address these deficiencies with the same sense of
urgency as the criminal prosecution of fraudulent providers.
If you have been contacted
concerning an overpayment or a possible criminal investigation, contact the
experienced and professional fraud team at Fausone Bohn, LLP for sound legal
advice. Contact Breeda O’Leary at (248)
380-0000 or online at www.MichiganFraudLawyer.com.
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article about the deficiencies in Medicare’s new accounting system, please
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